儿童下颌骨良恶性病变的影像学分析  

Imaging analysis of benign and malignant pediatric mandibular lesions

作　　者：李欣蓓[1] 初建平[1] 王玉亮[1] 杨智云[1] 

机构地区：[1]中山大学附属第一医院影像科,广东广州510080

出　　处：《影像诊断与介入放射学》2014年第6期501-505,共5页Diagnostic Imaging & Interventional Radiology

基　　金：中山大学青年教师培育计划(13ykpy14)

摘　　要：目的分析小儿下颌骨常见病变的影像学表现,提高诊断水平。方法搜集2008年1月-2014年9月我院收治的14岁以下儿童的下颌骨肿瘤、肿瘤样病变及炎性病变共27例,根据发病部位、骨质破坏及软组织肿块情况,回顾性分析其影像学表现。结果 27例病例中,良性病变10例,恶性病变13例及郎格罕氏细胞组织细胞增生症4例。良性病变以牙源性囊肿为主,病灶边界多清晰,骨质呈膨胀性改变,可有分隔及硬化边,无软组织肿块。恶性病变以小圆细胞肿瘤和转移瘤多见,可见骨质破坏及骨膜反应,边界欠清,累及牙根时可造成部分吸收,常伴有软组织肿块。需特别指出的是,虽然郎格罕氏细胞组织细胞增生症病理学为良性,但其生物学行为多表现为侵袭性或恶性,故需与恶性病变相鉴别。结论小儿下颌骨的病变复杂多样,但细致分析其影像学表现可缩小鉴别诊断范围,根据其特征提高诊断的准确性。Objective To study the imaging findings of common pediatric mandibular lesions.Methods The imaging findings of 27 children with 10 benign,13 malignant mandibular lesions and 4 Langerhans cell histiocytosis were retrospectively analyzed.Results Benign lesions were mainly odontogenic cysts with well-defined sclerotic margins,expansile septated bone absorption and no soft tissue mass.The malignant lesions included small round cell tumors and metastases with ill-defined boundary,bone destruction,periosteal reaction and no soft tissue mass.Although Langerhans cell histiocytosis is benign histologically,it has an aggressive biological behavior and should be distinguished from malignant lesions.Conclusion Diagnosis of pediatric mandibular lesions can be improved by carefully analyzing the imaging appearance.

关 键 词：小儿 下颌骨 体层摄影术 X线计算机 磁共振成像 

分 类 号：R739.82[医药卫生—肿瘤]